Frequently Asked Questions (FAQ)

When do you use the large Geistlich Bio-Oss® particles (1-2&nbspmm) and when the small (0.25-1&nbspmm)?

Fundamentally, the use of small particles is recommended for small defects (up to 2 dental alveoli) and for augmenting autogenous grafts, and the large particles for large defects (> 2 dental alveoli, sinus lifts). However, preferences can vary from dentist to dentist.

2.

Can Geistlich Bio-Oss® also be used without membrane?

A membrane should be used as a barrier against ingrowth of soft tissue1. Native collagen membranes such as Geistlich Bio-Gide® also support wound healing and increase therapeutic safety in the event of a postoperative wound dehiscence2,3. Physicians should read the package insert prior to use.

References:

Gielkens PF, et al.: Clin Oral Implants Res 2008; 19 : 516-21.

Tal H, et al.: Clin Oral Implants Res 2008; 19: 295-302.

Becker J, et al.: Clin Oral Implants Res 2009; 20(7): 742-49.

3.

Can Geistlich Bio-Oss® be re-sterilized?

No, if Geistlich Bio-Oss® is autoclaved, moisture can collect in the particles due to the high porosity of the product, which can change the hydrophilic properties. Moreover, Geistlich Bio-Oss® is not approved for re-sterilization in dental practice. Geistlich does not recommend re-sterilization under any circumstances.

4.

Should Geistlich Bio-Oss® be mixed with antibiotics?

The use of local antibiotics is generally unnecessary when utilizing Geistlich Bio-Oss®.

5.

Is Geistlich Bio-Oss® safe (transmission of diseases such as BSE)?

Geistlich Bio-Oss® is made from the mineral part of bovine bone. The strictly controlled manufacturing process ensures high quality and safety standards by:

Country of origin: Australia (and for some countries also New Zealand)

Selected and certified slaughterhouses

Pre- and post-mortem health inspection for each individual animal

Extremity bone (according to WHO Guideline on tissue infectivity classified as tissues with no detected infectivity or infectious prions)

Effective inactivation methods with 15h treatment at high temperature and cleaning with strong alkaline solutins

Sterilization, double sterile packaging

Official controls by international authorities

6.

Do I have to use venous blood or can I use blood from the defect?

Blood from the defect may be used for mixing. Care should be taken to avoid contamination with salivary bacteria.

Geistlich Bio-Oss Pen®

1.

When do you use the large Geistlich Bio-Oss Pen® particles (1-2 mm) and when the small (0.25-1 mm)?

Fundamentally, the use of small particles is recommended for small defects (up to 2 dental alveoli) and for augmenting autogenous grafts, and the large particles for large defects (> 2 dental alveoli, sinus lifts). However, preferences can vary from dentist to dentist.

2.

Can Geistlich Bio-Oss Pen® also be used without membrane?

A membrane should be used as a barrier against ingrowth of soft tissue1. Native collagen membranes such as Geistlich Bio-Gide also support wound healing and increase therapeutic safety in the event of a postoperative wound dehiscence2,3. Physicians should read the package insert prior to use.

References:

Gielkens PF, et al.: Clin Oral Implants Res 2008; 19: 516-21.

Tal H, et al.: Clin Oral Implants Res 2008; 19: 295-302.

Becker J, et al.: Clin Oral Implants Res 2009; 20(7): 742-49.

3.

How much saline or blood is needed to moisten the Geistlich Bio-Oss Pen®?

How many Geistlich Bio-Oss Pen® are needed for a sinus floor elevation?

Depending on the size of the defect between 1.5 to 4 cc of Geistlich Bio-Oss® granules are needed, or 3cc in average. This is equivalent to two 1.5cc Geistlich Bio-Oss Pen® with large granules or three 1cc Geistlich Bio-Oss Pen® with small granules.

5.

Can the Geistlich Bio-Oss® granules be mixed with autologous bone in the Geistlich Bio-Oss Pen®?

No.

6.

Can the Geistlich Bio-Oss Pen® be re-sterilized?

Geistlich Bio-Oss Pen® is not approved for re-sterilization.

7.

What to do if the applicator tip is contaminated (e.g. has fallen on the floor)?

Use a new Geistlich Bio-Oss Pen®.

8.

Can separate applicator tips be ordered?

No.

9.

Are other applicator tips (forms, length, diameter) available?

No.

Geistlich Bio-Oss® Collagen

1.

Is Geistlich Bio-Oss® Collagen a collagen plug?

No. Geistlich Bio-Oss® Collagen is a mixture of 90% Geistlich Bio-Oss® spongiosa granules and 10% highly purified porcine collagen in a block form. Geistlich Bio-Oss® is a natural bone mineral of bovine origin. The collagen facilitates adaptation of the Geistlich Bio-Oss® to the defect site.

2.

Do I need a membrane when using Geistlich Bio-Oss® Collagen?

The collagen in Geistlich Bio-Oss® Collagen does not function as a membrane. When the socket is not intact, it is recommended to use a membrane to receive optimal results1.

Geistlich Combi-Kit Collagen is recommended for the reconstruction of the alveolar ridge, extraction socket management and augmentation of bone dehiscences.

2.

Can I use Geistlich Combi-Kit products separately?

Geistlich Combi-Kit Collagen is packed in a double blister. After the outer blister has been opened sterility can no longer be guaranteed. The product Geistlich Combi-Kit Collagen is registered for one time use only. It is not recommended to use the products separately.

3.

Is it possible to get an allergic reaction to Geistlich Bio-Oss® Collagen and Geistlich Bio-Gide®?

Since Geistlich Bio-Oss® Collagen and Geistlich Bio-Gide® are made of collagen, allergic reactions and inflammatory tissue reactions cannot be ruled out. These are, however, extremely rare.

4.

Why Geistlich Bio-Gide®? How does it differ from other collagen membranes?

Geistlich Bio-Gide® is a membrane with a unique bilayer structure. It combines optimal bone formation with complication –free wound healing and predictable outcomes. An exceptional number of scientific publications and proven long-term success underline the unparalleled performance of Geistlich Bio-Gide®.

Perio-System Combi-Pack

1.

Can you use Perio-System Combi-Pack products separately?

Perio-System Combi-Pack is packed in a double blister. After the outer blister has been opened, product sterility can no longer be guaranteed. The product Perio-System Combi-Pack is registered for single use only.

2.

Why do I need Geistlich Bio-Gide® Perio when using Geistlich Bio-Oss® Collagen?

The collagen in Geistlich Bio-Oss® Collagen does not function as a membrane. In guided bone regeneration (GBR) procedures a membrane is indicated to obtain optimal results.1

Is it possible to get an allergic reaction to Geistlich Bio-Gide® Perio or Geistlich Bio-Oss® Collagen?

Since Geistlich Bio-Gide® Perio and Geistlich Bio-Oss® Collagen are made of collagen, allergic reactions and inflammatory tissue reactions cannot be ruled out. These are, however, extremely rare.

Geistlich Bio-Gide®

1.

Why is a membrane necessary?

Alveolar bone best regenerates with a membrane designed for Guided bone regeneration. The use of a membrane leads to more and better bone compared to procedures that do not include a membrane.1

References:

Schwarz F, et al.: Clin Oral Impl Res 2008; 19(4): 402-15.

2.

How long should a membrane function as a barrier in Guided Bone Regeneration?

Expert oral surgeons have estimated that a membrane used in Guided Bone Regeneration should maintain its barrier function until the provisional matrix and woven bone are present. Barrier duration is considered to be necessary for 7 to 14 days, in most cases. Optimal barrier function now means that occlusiveness is maintained until the wound heals – a process which normally takes about 2 weeks.Geistlich Bio-Gide® has proven to support bone regeneration on an equivalent level as membranes with a longer barrier function, with the additional benefit of complication-free wound healing.1-3

References:

Tal H, et al.: Clin Oral Impl Res 2008; 19: 295-302.

Becker J, et al.: Clin Oral Impl Res 2009; 20(7): 742-49.

Schwarz F, et al.: Clin Oral Impl Res 2008; 19(4): 402-15.

3.

Why Geistlich Bio-Gide®? How does it differ from other collagen membranes?

Geistlich Bio-Gide® is a membrane with a unique bilayer structure. It combines optimal bone formation with complication-free wound healing and predictable outcomes. The native collagen of Geistlich Bio-Gide® leads to significantly less dehiscence compared to artificially cross-linked membranes.4 An exceptional number of scientific publications and proven long-term success underline the unparalleled performance of Geistlich Bio-Gide®.

References:

Tal H, et al.: Clin Oral Impl Res 2008; 19: 295-302.

4.

Have inflammatory reactions been associated with Geistlich Bio-Gide®?

Inflammation is a possible complication, which may occur with any surgery. However, biocompatibility of Geistlich Bio-Gide® has been verified by testing.

5.

Is it possible to get an allergic reaction to Geistlich Bio-Gide®?

Since Geistlich Bio-Gide® is made of collagen, allergic reactions and inflammatory tissue reactions cannot be ruled out. These are, however, extremely rare.

6.

What happens if the membrane is applied side-inverted (rough side towards soft tissue)?

The compact layer of Geistlich Bio-Gide® exhibits higher cell occlusiveness than the rough, porous layer. If the membrane is applied side-inverted, integration of the bone cells may take place rather more slowly. However, it is not necessary to remove the membrane.

7.

Can Geistlich Bio-Gide® be re-sterilized?

No, autoclaving or hot-air sterilization irreversibly destroys the collagen structure. The physical properties of the membrane are changed and the consistency of the product becomes like parchment paper. The membrane may not be used. In this case, Geistlich as the manufacturer, cannot accept product liability because the product is not approved for re-sterilization.

8.

Does the membrane have to be fixed?

Since Geistlich Bio-Gide® adheres very well to the defect, it is normally not necessary to utilize fixation screws or pins. However, fixation is possible.

9.

How can Geistlich Bio-Gide® be used in extraction socket management for open healing?

Geistlich Bio-Gide® can heal submerged or open1 depending on the surgeons preference. The advantages of the secondary intention healing of Geistlich Bio-Gide® are the flapless surgery and the preservation of the mucogingival line.

What is the difference between the two collagen membranes Geistlich Bio-Gide® Compressed and Geistlich Bio-Gide®?

Geistlich Bio-Gide® Compressed has a smoother surface, a firmer feel and is easier to cut compared to Geistlich Bio-Gide®. Therefore, it offers an alternative handling for those dentists who prefer a firmer membrane. Geistlich Bio-Gide® Compressed is available in the sizes 13 x 25 mm and 20 x 30 mm. Availability may vary from country to country.

2.

For which indications is Geistlich Bio-Gide® Compressed intended and for which ones Geistlich Bio-Gide®?

mso-ansi-language:EN-US">Both Geistlich Bio-Gide® Compressed and Geistlich
Bio-Gide® are intended to be used as barrier membranes in the
regeneration of bone defects, for example in the context of Guided Bone
Regeneration, for delayed or immediate augmentation around implants,
reconstruction of the alveolar ridge, filling bone defects in the maxillofacial
area and cleft closure surgeries. For further details, please consult the
Geistlich Bio-Gide® and Geistlich Bio-Gide® Compressed IFU.

3.

Does the Geistlich Bio-Gide® Compressed membrane need to be fixated?

Penetration of the membrane by blood and exudate during
the surgery allows excellent adhesion of the membrane to the defect. Fixation
of the membrane with sutures or pins is possible due to its high tensile
strength. Fixation may be indicated to avoid membrane displacement due to shear
loading or mobilization.

Clinical performance of Geistlich Bio-Gide® Compressed is regarded the same as Geistlich Bio-Gide®. Various studies have shown that membranes of the Geistlich Bio-Gide® product family support excellent wound healing1-3 and predictable bone regeneration4.

Referenzen:

Tal H, et al.: Clin. Oral Implants Res 2008; 19: 295-302.

Zitzmann NU, et al.: Int J Oral Maxillofac Implants 1997; 12: 844-52.

Becker J, et al.: Clin. Oral Implants Res 2009; 20(7): 742-93.

Schwarz F, et al.: Clin Oral Implants Res. 2014, 25(9): 1010-15.

5.

What happens if the membrane is applied upside down (dense surface facing the bone, porous surface facing the soft-tissue)?

The dense layer
of Geistlich Bio-Gide® Compressed is more cell-occlusive than the
porous layer. Therefore, we advise to place the membrane as described in the
IFUs. However, it is not necessary to remove the membrane.

Geistlich Bio-Gide® Perio

1.

What is the difference between Geistlich Bio-Gide® Perio and Geistlich Bio-Gide®?

The surface of Geistlich Bio-Gide® Perio has been made firmer when dry to facilitate periodontal applications. Second, the outer blister pack of Geistlich Bio-Gide® Perio includes four sterile water repellent templates. These can be placed repeatedly in the region of the defect to allow customization of the template before cutting the membrane to the precise shape.

2.

Have inflammatory reactions been associated with Geistlich Bio-Gide® Perio?

Inflammation is a possible complication, which may occur with any surgery. However, biocompatibility of Geistlich Bio-Gide® Perio has been verified by testing.

3.

Is it possible to get an allergic reaction to Geistlich Bio-Gide® Perio?

Since Geistlich Bio-Gide® Perio is made of collagen, allergic reactions and inflammatory tissue reactions cannot be ruled out. These are, however, extremely rare.

4.

What happens if the membrane is applied side-inverted (rough side towards soft tissue)?

The compact layer of Geistlich Bio-Gide® Perio exhibits higher cell occlusiveness than the rough, porous layer. If the membrane is applied side-inverted, integration of the bone cells may take place rather more slowly. However, it is not necessary to remove the membrane.

5.

Can Geistlich Bio-Gide® Perio be re-sterilized?

No, autoclaving or hot-air sterilization irreversibly destroys the collagen structure. The physical properties of the membrane are changed and the consistency of the product becomes like parchment paper. The membrane may not be used. In this case, Geistlich as the manufacturer, cannot accept product liability because the product is not approved for re-sterilization.

6.

Does the membrane have to be fixed?

Since Geistlich Bio-Gide® Perio adheres very well to the defect, it is normally not necessary to utilize fixation screws or pins. However, fixation is possible.

Geistlich Bio-Gide®Shape

1.

What is the difference between Geistlich Bio-Gide® Shape and Geistlich Bio-Gide®?

In general, Geistlich Bio-Gide® Shape is based on the Geistlich Bio-Gide® Perio technology to facilitate application comfort. For easier handling, the membrane is pre-cut to a shape that fits for extraction sockets. This also reduces your preparation time.

2.

How should Geistlich Bio-Gide® Shape be placed?

Place the membrane without pre-wetting within the extraction socket. The long strap of the Geistlich Bio-Gide® Shape should be placed to cover the bony defect of the socket, if present. Thereby the dense surface should face towards the soft tissue, and the rough side should face the defect.

To close the extraction socket, both lateral wings of the Geistlich Bio-Gide® Shape membrane should be tucked underneath the mucosa, located mesially and distally of the socket. The upper wing should be tucked lingually / pallatinally in-between the soft tissue and bone wall.

3.

Should Geistlich Bio-Gide® Shape be placed inside or outside the alveolus?

The membrane should be placed inside the alveolus or outside (between the bone and the soft-tissue). From the convenience point of view, it might be easier to place Geistlich Bio-Gide® Shape inside the alveolus.

The long strap of the Geistlich Bio-Gide® Shape should be placed to cover the bony defect of the socket, if present. Thereby the dense surface should face towards the soft tissue, and the rough side should face the defect.

4.

How can Geistlich Bio-Gide® Shape be sutured?

Fixation of the membrane (e.g. mattress suture) on top may be indicated to avoid its displacement due to shear loading or mobilization.

5.

When should Geistlich Bio-Gide® Shape be used, when Geistlich Mucograft® Seal?

Geistlich Bio-Gide® Shape and Geistlich Bio-Oss® Collagen can be used in combination for the treatment of extraction sockets with non-intact buccal bone walls.

The use of Geistlich Mucograft® Seal and Geistlich Bio-Oss® Collagen is recommended in extraction sockets with intact buccal bone walls.1

The device will gain approx. 25% in volume once wet. This increase in volume has to be taken into account when deciding upon final dimensions. A generous flap design is the key to full submersion of the matrix.

2.

What is the indication of Geistlich Fibro-Gide®?

Geistlich Fibro-Gide®
is intended to be used for soft-tissue regeneration at the alveolar ridge.
Indications of Geistlich Fibro-Gide® are insufficient soft-tissue volume and
recession defects.

3.

What is Geistlich Fibro-Gide® made of?

Geistlich Fibro-Gide® is a porcine, porous, resorbable and volume-stable collagen matrix specifically designed for soft-tissue regeneration. The matrix is made of reconstituted collagen undergoes smart chemically cross-linking to improve volume stability of the device while maintaining its excellent biocompatibility.

4.

Is Geistlich Fibro-Gide® resorbable?

Animal models have shown good integration of Geistlich Fibro-Gide® into the surrounding soft-tissue combined with the ability to degrade and be replaced by connective tissue while maintaining three dimensional volumetric stability over time.

5.

Is Geistlich Fibro-Gide® an alternative to free gingival graft (FGG) or to connective tissue grafts (CTG)?

Geistlich Fibro-Gide® is an alternative to autologous connective tissue grafts (CTG) for soft-tissue volume augmentation around dental implants and natural teeth. Geistlich Fibro-Gide® obviously has the advantage of reducing patient morbidity since there is no additional harvest site. Furthermore, there is no risk of necrosis when using Geistlich Fibro-Gide® compared to CTG.

6.

Does Geistlich Fibro-Gide® need pre-treatment?

Geistlich Fibro-Gide® is ready to be applied to the defect and does not need pretreatment or conditioning before application. Geistlich Fibro-Gide® possesses excellent hydrophilic characteristics that lead to a rapid hydration of the collagen matrix (patient’s own blood and/or sterile saline). When applied dry to the defect site, the matrix will hydrate easily by soaking up patient’s own blood and/or sterile saline very fast.

7.

Should Geistlich Fibro-Gide® be handled/applied wet or dry?

Geistlich Fibro-Gide® can be applied either in a dry or wet state subject to individual preference: pre-wetting can be done with blood and/or sterile saline.Geistlich Fibro-Gide® can be cut and trimmed both in a dry or wet state, using scissors and/or a scalpel. The scalpel is recommended for dry handling. Using a scalpel will help to obtain smooth edges and tapers for improved wound adaptation and precise fit of the matrix.

8.

Does Geistlich Fibro-Gide® increase its volume after implantation?

The device will gain approx. 25% in volume once wet. This increase in volume has to be taken into account when deciding upon final dimensions. A generous flap design is the key to full submersion of the matrix.

9.

Which flap design is recommended when using Geistlich Fibro-Gide®?

Use your preferred flap design. A generous preparation of the flap is key to promoting successful healing by complete coverage of Geistlich Fibro-Gide® (submerged healing). Different surgical techniques, such as tunneling and/or envelope techniques are currently being clinically tested (not all under studies).

10.

What suture should be used with Geistlich Fibro-Gide®?

Clinical experience has shown that tension-free wound closure is a key factor in preventing dehiscence. In open flap procedures for augmentation at the alveolar ridge a horizontal mattress suture is recommended to stabilize the matrix (5.0-6.0). In recession coverage single sutures (7.0) have been used for stabilization. Suturing of Geistlich Fibro-Gide® to the wound bed is not necessary due to its excellent hydrophilicity and adaptation.

11.

How should the flap be closed with Geistlich Fibro-Gide® underneath?

A tension-free closure of the flap is key to a successful and complication-free healing and avoidance of any dehiscences during the healing phase. Please avoid compression of Geistlich Fibro-Gide® at the defect site.

12.

Are antibiotics needed after treatment with Geistlich Fibro-Gide®?

After treatment with Geistlich Fibro-Gide®, please follow the same postsurgical management that is usually applied with connective tissue grafts.

13.

What is the difference between Geistlich Fibro-Gide® and Geistlich Mucograft®?

Geistlich Mucograft®

Geistlich Fibro-Gide®

Compact and spongy layer

Porous layer

Reconstituted collagen – no cross-linking

Reconstituted collagen – gentle cross-linking

Reduced volume stability

Good volume stability

Open-healing & submerged healing

Submerged healing only

Treatment Option

Gain of keratinized tissue

Socket Seal

Vestibuloplasty

Recession Coverage

Treatment Option

Soft-tissue volume augmentation around dental implants and natural teeth, and under pontics

Recession Coverage

14.

How much thickness of Geistlich Fibro-Gide® is required in order to obtain a thickening of the soft-tissue comparable to when connective tissue graft (CTG) is used?

Clinical studies have shown a physiological increase in thickness when using CTG as the gold standard of 0.35 to 3.2 mm. Clinical studies have shown that treatment with Geistlich Fibro-Gide® results in an increase of 1-2 mm of thickness which is equivalent to results obtained with CTG. Geistlich Fibro-Gide® is provided with a thickness of 6 mm which gives freedom to the surgeon to trim it to the desired size and to use the collagen matrix for thickening of tissues under pontics where more volume might be required. For lateral soft-tissue augmentation, it is recommended to reduce the thickness of Geistlich Fibro-Gide® in order to achieve a tension-free, primary wound closure.

15.

When should the regenerated soft-tissue be stimulated or loaded?

Loading with minimal pressure can be done immediately after surgery, taking into account the swelling due to the intervention. Loading by applying pressure can be performed as soon as the site has healed 3-8 weeks after grafting and should not be delayed more than 3 months. This might be beneficial for conditioning the new soft-tissue and favoring its maturation based on experience from clinical studies.

16.

Is over-augmentation with Geistlich Fibro-Gide® needed in order to obtain a soft-tissue volume increase?

It is important to adjust the size of Geistlich Fibro-Gide® to the dimensions of the defect site, taking swelling into consideration, in order to ensure tension-free wound closure. Slight over-augmentation with Geistlich Fibro-Gide®, on the contrary, might be needed (similar to Guided Bone Regeneration), but tension-free wound closure is key.

17.

Does Geistlich Fibro-Gide® turn into scar tissue? What happens after 1 year?

The result of the whole remodeling process of Geistlich Fibro-Gide® is the formation of new soft-tissue (connective tissue). Animal models have shown good integration of Geistlich Fibro-Gide® into the surrounding soft-tissue without formation of scar tissue.

Geistlich Mucograft®

1.

What is Geistlich Mucograft®?

Geistlich Mucograft® is a unique 3D-collagen matrix designed specifically for soft-tissue regeneration as an alternative for autogenous soft-tissue grafts.

2.

What is Geistlich Mucograft® made of?

Geistlich Mucograft® consists of porcine collagen and is specifically designed for soft-tissue regeneration. The matrix is built up of a compact structure that gives stability while allowing open healing, and a spongy structure that supports blood clot stabilisation and ingrowth of soft-tissue cells.

3.

Is Geistlich Mucograft® resorbable?

The collagen of Geistlich Mucograft® will be replaced by newly formed soft tissue. The matrix is rapidly vascularised and colonised by soft-tissue cells. This leads to a good integration of the matrix without any signs of foreign body reaction1,2.

Is Geistlich Mucograft® an alternative for free gingival graft (FGG) or for connective tissue graft (CTG)?

For both. Geistlich Mucograft® is an alternative to free gingival graft or connective tissue graft for gaining keratinised tissue1-3. Geistlich Mucograft® is an alternative to CTG for recession coverage4-6.

Geistlich Mucograft® is ready to be applied to the defect and does not need pretreatment or moisture before application. Due to its excellent hydrophilicity, the matrix will hydrate quickly after implantation in the defect by soaking rapidly the patient’s blood.

Our measurements indicate that the matrix does not swell further after hydration (90 minute period examined)1.

References:

Data on file, Geistlich Pharma AG, Wolhusen, Switzerland

8.

Can Geistlich Mucograft® be stretched?

No. Geistlich Mucograft® shows a limited elongation and should always be sutured tension-free.

9.

What suture should be used with Geistlich Mucograft®?

Published data show different suturing techniques with Geistlich Mucograft®: non-resorbable1,2 and resorbable3, 0-51,2 and 0-64. There is no clinical evidence showing a benefit of one type of suture over another one, when suturing Geistlich Mucograft®.

References:

Sanz M, et al.: J Clin Periodontol 2009; 36(10): 868-76.

Herford AS, et al.: J Oral Maxillofac Surg 2010; 68(7): 1463-70.

Cardaropoli D, et al.: J Periodontol 2012; 83(3): 321-28.

McGuire MK & Scheyer ET : J Periodontol 2010; 81(8): 1108-17.

10.

Which side of Geistlich Mucograft® should face the bone?

The compact structure should face outward, away from underlying bone, with the spongeous structure facing the bone or soft-tissue wound bed. Neither clinical nor comparative data on inverted device performance is available for Geistlich Mucograft®.

11.

How many layers of Geistlich Mucograft® should be used?

In the majority of the individual cases treated thus far and for all the studies performed with Geistlich Mucograft®, one matrix layer was used. Presently, clinical data is not available to prove that several layers of the device outperform a single layer of Geistlich Mucograft®.

12.

Should Geistlich Mucograft® be placed directly over the bone or over the periosteum?

It depends on the indication:1. Gain of keratinised tissue: Geistlich Mucograft® should be applied on a periosteal bed1,2 since blood supply is important. In open healing, the blood is supplied through the edges of the device from the surrounding tissue and from the periosteum.2. Recession Coverage: Geistlich Mucograft® can be used partially or completely over bone.3-5 Blood is supplied through the edges of the device from the surrounding tissue and from the flap covering completely the matrix.References:

Should Geistlich Mucograft® be used submerged or in open healing situations?

It depends on the indication:1. Gain of Keratinised Tissue: Open healing is recommended when Geistlich Mucograft® is used to increase width of keratinised tissue. The innovative design of Geistlich Mucograft® allows excellent healing in open healing situations1.2. Recession Coverage: Geistlich Mucograft® should remain completely submerged under the flap to avoid premature resorption of the collagen.2-4 Direct blood supply is important.

After treatment with Geistlich Mucograft®, please follow the same postsurgical management that is usually applied with connective tissue grafts or free gingival grafts.

Geistlich Mucograft® Seal

1.

What’s the difference between collagen sponges made by other manufacturers and Geistlich Mucograft® Seal?

Geistlich Mucograft® Seal is specifically designed for soft-tissue regeneration1. The collagen of Geistlich Mucograft® is specially processed to favour immediate blood clot stabilisation. This leads to early vascularisation1,3, facilitates soft-tissue cell ingrowth2 and excellent integration of the 3D-matrix with surrounding tissues2,3. In contrast to other collagen products in the market, Geistlich Mucograft® and Geistlich Mucograft® Seal are well scientifically documented and their clinical benefits are proven.

The resorption time of every biomaterial including Geistlich Mucograft® Seal depends on multiple factors: defect size, metabolism and general health of the patient, etc. On the other hand, to determine an average resorption time of Geistlich Mucograft® Seal in humans, biopsies would be needed of the healing soft tissues after tooth extraction at different time points. This procedure is obviously not ethical and thus the average resorption time cannot be measured. However, single histologies indicate that after 8 weeks Geistlich Mucograft® is completely integrated into the newly formed soft tissue.

3.

Does Geistlich Mucograft® Seal take up blood and saline equally well?

The hydrophile properties of Geistlich Mucograft® Seal favour a rapid moistening of the device either with saline or with blood.

4.

Why should I use Geistlich Bio-Oss Collagen® with Geistlich Mucograft® Seal, if I plan to implant after 8-10 weeks?

Geistlich Mucograft® Seal needs the support of Geistlich Bio-Oss® Collagen underneath for a good ridge preservation of the soft and the hard tissues. After 8 weeks, the soft tissues are healed but the mixture of the blood clot, Geistlich Bio-Oss® Collagen and the newly forming bone is still soft. Nevertheless the implant can be drilled carefully into the socket and the remaining Geistlich Bio-Oss® Collagen will favour the volume preservation of the ridge.

5.

What is Geistlich Mucograft® Seal?

Geistlich Mucograft® Seal is a unique 3D-matrix designed specifically for soft-tissue regeneration in extraction sockets for ridge preservation.

6.

What is Geistlich Mucograft® Seal made of?

Geistlich Mucograft® Seal consists of porcine collagen and is specifically designed for soft-tissue regeneration. The matrix is built up of a compact structure that gives stability while allowing open healing, and a spongy structure that supports blood clot stabilisation and ingrowth of soft-tissue cells.

7.

Is Geistlich Mucograft® Seal resorbable?

The collagen of Geistlich Mucograft® will be replaced by newly formed soft tissue. The matrix is rapidly vascularised and colonised by soft-tissue cells1,2. This leads to a good integration of the matrix without any signs of foreign body reaction3,4.

Geistlich Mucograft® Seal is ready to be applied to seal the socket and does not need pretreatment or moisture before application. Due to its excellent hydrophilicity, the matrix will hydrate quickly after implantation in the defect by soaking rapidly the patient’s blood.

Our measurements indicate that the matrix does not swell further after hydration (90 minute period examined)1.

References:

Data on file, Geistlich Pharma AG, Wolhusen, Switzerland

11.

Which side of Geistlich Mucograft® Seal should face the bone?

The compact structure should face outward, away from underlying bone, with the spongeous structure facing the bone or soft-tissue wound bed. Geistlich Mucograft® Seal spongeous structure is striped for easier differentiation of the two sides. The striped spongeous structure should face the bone.

Geistlich Mucograft® Seal should be sutured using non-resorbable sutures, not glued1. The close adaptation of the device to tissue borders can be accomplished by single interrupted sutures, double interrupted sutures, cross sutures, or sling sutures1.The finest possible suture material comfortably used by the surgeon should be selected: for single interrupted sutures, the 6.0 or 5.0 suture size is recommended; for cross-suturing, a 5.0 suture size is appropriate1.

Which Geistlich biomaterials do you recommend for the treatment of extraction sockets?

Both Geistlich Bio-Oss® OR Geistlich Bio-Oss® Collagen AND Geistlich Bio-Gide® are recommended for bone regeneration in the management of extraction sockets with defect bone walls. When Geistlich Bio-Oss® and Geistlich Bio-Gide® are used in combination, more new bone is obtained compared to extraction site using only a bone substitute material1.

The use of Geistlich Mucograft® Seal and Geistlich Bio-Oss® Collagen is recommended in extraction sockets with intact buccal bone wall2.

Geistlich Bio-Gide® Shape and Geistlich Bio-Oss® Collagen can be used in combination for the treatment of extraction sockets with non-intact buccal bone wall.

Can Geistlich Bio-Gide® be used in extraction socket management for open healing? How?

Geistlich Bio-Gide® can be healed submerged or open1 depending on the surgeons preference. The advantages of the secondary intention healing of Geistlich Bio-Gide® are the flapless surgery and the preservation of the mucogingival line.

Why should I use Geistlich Bio-Oss® Collagen with Geistlich Mucograft® Seal, if I plan to implant after 8-10 weeks?

Geistlich Mucograft® Seal needs the support of Geistlich Bio-Oss® Collagen underneath for a good ridge preservation of the soft and the hard tissues. After 8 weeks, the soft tissues are healed but the mixture of the blood clot, Geistlich Bio-Oss® Collagen and the newly forming bone is still soft. Nevertheless the implant can be drilled carefully into the socket and the remaining Geistlich Bio-Oss® Collagen will favour the volume preservation of the ridge.

9.

Can Geistlich Mucograft® Seal be used in extraction socket management for open healing? How?

Yes. Geistlich Mucograft® Seal is an alternative to autogenous soft-tissue graft for soft-tissue regeneration. Geistlich Mucograft® Seal does not require pre-hydration or washing. It should be handled and applied in a dry state. Before applying Geistlich Mucograft® Seal, adjacent soft-tissue margins should be de-epithelialized. This allows epithelial cells to freely migrate from the soft-tissue borders into the matrix.

Soft-Tissue Regeneration

1.

Why do I need keratinized tissue?

Investigators still cannot agree on the importance of the presence of keratinised tissue. Various studies have shown, however, that lack of keratinised tissue around implants is associated with

Gingival recession over a period of five years1

Soft-tissue attachment loss2

Increased plaque accumulation lingually1

Inflammation of the soft tissue2

More frequent bleeding1

References:

Schrott AR, et al.: Clin Oral implants Res 2009; 20(10): 1170-17.

Chung DMT, et al.: J Periodontol 2006; 77(8): 1410-20.

Pharmaceutical Products

Geistlich TauroSept®

1.

What is Geistlich TauroSept®?

Geistlich TauroSept® is an antimicrobial catheter lock solution for the prevention and treatment of catheter associated infections and is suitable for use for all tunnelled and non-tunnelled vascular access and port systems.

Geistlich TauroSept® is effective against a broad range of bacteria and fungi, including antibiotic-resistant micro-organisms such as methicillin-and vancomycin-resistant bacteria. The particular mechanism of action prevents development of resistance. Geistlich TauroSept® inhibits the adherence of bacteria to human epithelial tissue and biomaterials. In catheter and port systems, Geistlich TauroSept® prevents biofilm formation and possible colonisation of the system by micro-organisms.

4.

Are there any known side effects with the use of Geistlich TauroSept®?

No. When Geistlich TauroSept® is used as indicated in the instructions for use, neither local nor systemic side effects are known.

5.

How should Geistlich TauroSept® be used?

After flushing the vascular access system with 10 ml of normal saline, Geistlich TauroSept® is drawn up using a syringe and instilled into the vascular access system. The required filling volume is found in the respective catheter manufacturer's instructions for use. Filling should be done according to these instructions. It must always be ensured that the entire cavity of the catheter is filled. Underfilling should be avoided. Geistlich TauroSept® remains in the access system until the next treatment (but for at least 30 minutes). Before the catheter is used the next time, Geistlich TauroSept® must be aspirated from the catheter and disposed of.

6.

Is there a risk if Geistlich TauroSept® is accidentally injected into the bloodstream?

No. Taurolidine is metabolised rapidly in the body via the metabolites taurultam and methylol taurinamide, which are also bactericidal, to taurine, an endogenous aminosulphonic acid, CO2 and H2O. Therefore, no toxic effects are known or to be expected in the event of accidental injection. Clinically relevant adverse effects are also very unlikely because of the low concentration and the low volume in the catheter in relation to the total volume of the circulation.

7.

What precautions should be observed when Geistlich TauroSept® is used?

Geistlich TauroSept® must not be mixed with oxidising agents such as sodiumhypochlorite (Dakin solution), iodine or povidone iodine, hydrogen peroxide or other substances with an oxidising action as otherwise formic acid is formed. Normal skin disinfection is not affected by this restriction.

8.

Can unneeded leftover Geistlich TauroSept® be stored or sterilised?

No. Leftover Geistlich TauroSept® must always be discarded and cannot be resterilised. Damaged packs must be regarded as unsterile and accordingly be disposed of.

9.

Can Geistlich TauroSept® cause damage to the catheter?

No. Geistlich TauroSept® does not lead to any damage to the catheter material, regardless of what type of catheter is used.

10.

Can heparin or plasminogen activators (r-tPA) be added directly to a Geistlich TauroSept® solution if necessary?

Yes. If necessary, Geistlich TauroSept® can be mixed directly with heparin or plasminogen activators (r-tPA) and administered together. The activity of these substances is not influenced by Geistlich TauroSept®. Geistlich TauroSept® has not exhibited any influence on heparin activity in in vitro studies, animal studies and clinical studies.

11.

Can prefilled Geistlich TauroSept® syringes be stored for a longer period?

No. The most important rule in dealing with a catheter and port system is observation of strict hygiene regulations. These rules are infringed with advance mixing or stocking up with prefilled syringes. The requirements for optimally sterile work are no longer met as a result.

12.

Are laboratory parameters altered or influenced when Geistlich TauroSept® is used?

No. Geistlich TauroSept® is a bactericidal and antiadhesive catheter / port lock solution and does not contain any anticoagulants such as heparin or citrate. Even if there should be small traces of Geistlich TauroSept® in the catheter, this does not influence the result of a blood test.

Jobs & Career

Application procedure

1.

How do I best apply?

The first impression counts! In order for us to receive the most detailed picture possible of your qualifications and interests, your particulars should be carefully compiled and be comprehensive. Please send your application to recruiting@geistlich.ch. Your data are thus passed directly to the HR responsible. This way we can speed up the application procedure.

Your application should contain a covering letter and your CV, as well as references and diplomas. For an application by email you can enclose these as attachments.

4.

What happens to my data after an application?

Your application is stored by us in our recruitment database. The data contained in your profile is treated confidentially and is used exclusively for the purpose of your application. Your data is only stored by us for as long as you are in the application process. When the recruiting process is completed without subsequent employment, your data will be deleted.

5.

What is the application procedure like at Geistlich Pharma AG?

For a decision on selection we would like to have a comprehensive impression of your capabilities, qualifications and your personality.

First interview:

After carefully checking your application documents and a positive assessment, you will be invited to a personal interview. During this interview one representative from the HR department and one from the appropriate specialist department will be present. The focus is on you as a person, individual sections of your CV and specialist questions. We would like to know why you are interested in the position and how you match the culture at Geistlich Pharma AG.

Second interview:

In a second interview we go more deeply into your specialist knowledge and clear up any unresolved questions from the first interview. We would also very much like to introduce you to other team members. Use this as an opportunity to ask us questions.

Patients

Dental Regeneration

1.

What is a biomaterial?

Biomaterials are non-viable materials that can be implanted to replace or repair missing tissue. They may be of natural origin or synthesised in a laboratory and are able to interact with the human body.

2.

When is a bone augmentation needed?

Dental implants: To support and augment the jaw bone when using dental implants, if the existing amount of bone is not sufficient for long-term stable tooth anchoring.

Periodontitis: To preserve existing teeth that have lost their secure anchorage in the jaw bone as a result of periodontal disease (e.g. due to bacterial tooth plaque).

Careful selection of raw materials for the manufacture of Geistlich Bio-Oss® and Geistlich Bio-Gide®, using bone substance or collagen only from monitored establishments.

Highly effective cleaning process using chemical and physical treatments and long periods of heating (Geistlich Bio-Oss®).

Monitored production process with regular checks by independent institutions and state authorities.

Sterilisation of end products.

Documented quality assurance system.

4.

What happens after a tooth removal?

The bone recedes in the weeks and months after tooth removal. This might cause some of the following problems:

Aesthetic impairment: The gum follows the receding bone leading to visible blemishes.

Hygiene problems: If you wear a bridge, the resulting gaps can make it more difficult, or impossible to clean.

Difficulty with articulation: The change in the mouth affects articulation.

Expensive and complicated follow-up treatments: The loss of bone has to be compensated later with laborious bone and soft-tissue augmentation.

5.

What evidence is there that the biomaterials from Geistlich really work?

Geistlich Bio-Oss® and Geistlich Bio-Gide® have been part of the standard therapy in the field of bone reconstruction by dentists and dental surgeons for many years. They are the biomaterials most frequently used in regenerative dental medicine throughout the world. Geistlich Bio-Oss® and Geistlich Bio-Gide® have been used many million times, so extensive amounts of data and reports of experience exist. In addition, a great number of clinical studies document the reliability of both products.

6.

What happens to the biomaterials after the implantation?

Geistlich Bio-Oss® is intermingled with new bone after four to six months and is then included in the natural remodelling process of the bone. The protective Geistlich Bio-Gide® membrane is broken down naturally by the body after a few weeks.

7.

What are the causes of bone loss?

Bone loss can have many different causes – e. g. accidents, or inflammation of the gums and bone due to bacterial tooth plaque (periodontitis). Also after teeth have been removed the height and thickness of the jaw bone diminishes due to the lack of mechanical loading.